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A patient presents with sudden-onset, painless vision loss in the right eye. Fundoscopic examination reveals a cherry-red spot at the macula and attenuated retinal vessels. Which of the following conditions is most likely responsible for this presentation?
- A. Central retinal artery occlusion
- B. Central retinal vein occlusion
- C. Retinal detachment
- D. Acute angle-closure glaucoma
Correct Answer: A
Rationale: The presentation of sudden-onset, painless vision loss in the right eye with a cherry-red spot at the macula and attenuated retinal vessels is classic for central retinal artery occlusion (CRAO). In this condition, the blockage of the central retinal artery results in severe ischemia of the retina, leading to rapid and profound vision loss. The cherry-red spot at the macula is a result of preserved choroidal circulation contrasting with the pale, ischemic retina. Attenuated retinal vessels are also commonly observed due to decreased blood flow. Prompt evaluation and management are critical in CRAO to potentially restore some vision and prevent further ischemic damage to the retina.
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Which of the following interventions is recommended for managing a patient with a suspected opioid overdose?
- A. Administering naloxone intravenously.
- B. Providing respiratory support with bag-valve-mask ventilation.
- C. Encouraging the patient to drink fluids rapidly.
- D. Administering benzodiazepines for sedation.
Correct Answer: A
Rationale: Naloxone is a medication used to reverse the effects of an opioid overdose by binding to opioid receptors and displacing the opioids. Administering naloxone intravenously is the recommended intervention for managing a patient with a suspected opioid overdose as it can quickly reverse respiratory depression, sedation, and other effects of opioids. This intervention can be life-saving in cases of opioid overdose and is a critical step in the management of such patients. Providing respiratory support with bag-valve-mask ventilation may be necessary in addition to naloxone administration to ensure adequate oxygenation, but naloxone remains the primary intervention to reverse the effects of opioids. Encouraging the patient to drink fluids rapidly or administering benzodiazepines for sedation are not recommended interventions for managing a suspected opioid overdose.
A patient is exhibiting classic sign of a hemorrhagic stroke. What report from the patient would be an indicator of this type of stroke?
- A. Numbness of an arm or leg
- B. Severe headache
- C. Double vision
- D. Dizziness and tinnitus
Correct Answer: B
Rationale: A severe headache is a classic sign of a hemorrhagic stroke. Hemorrhagic stroke occurs when a blood vessel in the brain ruptures and causes bleeding. This bleeding can lead to increased pressure within the skull, resulting in a sudden and severe headache. Other symptoms of a hemorrhagic stroke may include nausea, vomiting, sudden weakness or numbness on one side of the body, difficulty speaking or understanding speech, and loss of coordination. It is important to seek immediate medical attention if someone is experiencing symptoms of a stroke, including a severe headache, as prompt treatment is crucial in minimizing damage and improving outcomes.
Whose responsibility is it to obtain informed consent?
- A. Nurse Manager
- B. Physician
- C. Anesthesiologist
- D. Midwife
Correct Answer: B
Rationale: The responsibility of obtaining informed consent typically falls on the physician or the healthcare provider who is performing the procedure or treatment. Informed consent is a process where the healthcare provider explains the procedure, its risks, benefits, possible alternatives, and potential outcomes to the patient or their legal representative. The patient must have a comprehensive understanding of these aspects before agreeing to the treatment. While nurses, nurse managers, anesthesiologists, midwives, and other healthcare professionals may assist in the consent process by providing information or clarifications, the ultimate responsibility lies with the physician. This is because the physician is usually the one with the expertise and knowledge about the specific procedure or treatment being performed.
A patient with hypertension is prescribed an angiotensin-converting enzyme (ACE) inhibitor. Which adverse effect is most commonly associated with ACE inhibitors?
- A. Hyperkalemia
- B. Hypokalemia
- C. Dry cough
- D. Bradycardia
Correct Answer: C
Rationale: The most commonly associated adverse effect with ACE inhibitors is a dry cough. This cough is non-productive and can be quite bothersome for patients, often leading to non-compliance with the medication. The cough is thought to be due to the accumulation of bradykinin and substance P, which are vasodilatory and bronchoconstrictive peptides that are normally degraded by ACE. When ACE is inhibited, these peptides accumulate and can lead to irritation of the respiratory tract, resulting in the dry cough. It's important for healthcare providers to be aware of this common side effect and consider alternative medications if the cough becomes problematic for the patient.
A patient expresses fear of the unknown regarding an upcoming surgical procedure. What is the nurse's best response?
- A. Dismiss the patient's fear and assure them that the procedure is routine.
- B. Provide the patient with accurate information about the surgical procedure and what to expect.
- C. Ignore the patient's fear and proceed with scheduling the procedure.
- D. Tell the patient that fear of the unknown is irrational and unfounded.
Correct Answer: B
Rationale: The nurse's best response to a patient expressing fear of the unknown regarding an upcoming surgical procedure is to provide the patient with accurate information about the surgical procedure and what to expect. This approach empowers the patient with knowledge and helps alleviate anxiety by demystifying the unknown. By educating the patient about the procedure, potential risks, and postoperative care, the nurse can help the patient feel more prepared and in control of the situation. It is crucial for healthcare providers to address patient fears with compassion, understanding, and information to support the patient through the surgical process.